An SME hired to manage health traffic

We waste a lot of time waiting on the phone to get medical appointments. We’re losing it again at the clinic. In many cases, we went there for nothing. Financially, everyone loses, including workers, employers and the State.

Every election, it’s the same story, a new miracle solution is promised without anyone really believing in it. So when Santé Québec told me about Vitrai (pronounced stained glass), an SME in Estrie that had found a way to increase access to doctors, I was very skeptical.

Quebec believes in it so much that it has just signed a 40 million contract with the company founded by a former pharmacist at the Granby hospital, Alexandre Chagnon. For four years, its technology will be used by 811 (Info-Santé), Family Medicine Groups (GMF) and Front Line Access Counters (GAP).

Basically, Vitrai is a system that directs patients to the right professional – doctor, nurse, physio, pharmacist, social worker – by asking them a series of questions generated by artificial intelligence. The technology, which has existed for 7 years, is already used by 75 GMFs out of 400. At the beginning of next year, Vitrai must be integrated into online appointment booking platforms.

It seems too simple to have any real impact. However, this is the case, because we do not realize the phenomenal number of patients who show up at the doctor unnecessarily, the D told me^r Antoine Groulx. The general practitioner practices in a GMF in Quebec which has been using the Vitrai tool since the spring. His data is astounding.

In October, of the 1,431 people who called for an appointment, 415 were referred to another specialist, including 17 to the emergency room. The data for September is virtually identical.

This means that better triage makes it possible to offer at least 400 appointments per month to people who really need them. And this, in a single clinic. Imagine the impact across Quebec. It doesn’t solve everything, but it’s a promising boost.

“Nearly a third of consultations can be redirected, which is an impressive amount of time saved upstream,” enthuses the D^r Groulx. And this is time that was not easy to save without an algorithm because the staff who take the calls do not have the medical or clinical competence to make arbitrations. » In addition, the average call time went from 4.5 minutes to 1.5 minutes, thanks to the questions asked by Vitrai that you just have to follow. Secretaries and patients benefit.

This observation is consistent with the data collected by Alexandre Chagnon. Family doctors, he says, see 35.8% of patients who do not require their expertise. It’s so high it’s hard to believe. These consultations mainly concern musculoskeletal health (pain, lumbar or joint pain, back pain, knee pain), issues related to bereavement, mental health problems or even medication renewals.

But it’s hard to blame patients who no longer know who does what in our complex, ever-changing system.

In recent years, pharmacists have obtained the right to prescribe certain medications, but who knows the list by heart? And could you say what diagnoses specialist nurse practitioners are allowed to make? The normal reflex, faced with so much unknown, is to seek to see a doctor.

The D^r Groulx also believes that we would help the health system by improving patients’ knowledge so that they know how to determine what constitutes a good reason to consult, starting in elementary school. “Our collective health literacy is catastrophic in Quebec. We are dunces. » He does not expect that we will be able to comment on inflammatory diseases, only colds, flu, fever.

We cannot blame the staff who take calls in a GMF, at GAP or at 811, either, believes Alexandre Chagnon. Because the work is constantly getting more complicated. “Last week, we adopted Bill 67, which aims to expand what pharmacists, physiotherapists and social workers can do. This will impact the criteria. When the medical secretaries begin to know them, they are changed on the basis of a bill. It’s excessively complex. »

The beauty of the matter is that artificial intelligence knows the service offerings in the region where the person lives in order to offer them a realistic solution.

The company created by Alexandre Chagnon employs around fifteen people who train the AI ​​and teach it that in Montmagny, “a collective prescription ensures that sinusitis can be treated by a nurse in a clinic, but only those who meet the criteria x, y and z, he gives as an example. It’s extremely precise.”

The 34-year-old ex-pharmacist gave up his hospital job and his pension plan, and put his house as collateral to start his business. He notes today that “you have to be crazy to go into business in the health system”, because “the sales cycle is measured in years”. But now that he has attracted the interest of the Quebec government, he hopes to sell his technology elsewhere in the country.

And we hope that Vitrai will fulfill its promise to accelerate access to doctors. In a health system that is failing everywhere, the slightest improvement would be an achievement.